{"title":"Fifty Years of Children's Nursing: Reflections on Practice, Research and Future Directions","authors":"Imelda Coyne","doi":"10.1111/jan.70486","DOIUrl":"https://doi.org/10.1111/jan.70486","url":null,"abstract":"","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"30 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mari Saukkoriipi, Outi Kanste, Erika Jarva, Pauliina Hyrkäs, Kristina Mikkonen
Aims To identify healthcare professionals' experiences of innovation competence and the factors associated with it; and to examine the instruments developed to assess innovation competence and its associated factors among healthcare professionals. Design A mixed‐methods systematic review. Methods Researchers independently screened original studies by title and abstract ( n = 2996) and then full text ( n = 189). Eighteen studies were included: 16 quantitative and two qualitative. Qualitative data were analysed using inductive content analysis, and quantitative data were tabulated and synthesised narratively. Data Sources The review followed the Joanna Briggs Institute Mixed Methods Systematic Review methodology. Searches were conducted in Scopus, CINAHL, Ovid Medline, ProQuest, Web of Science, PsycArticles, and Medic. Articles published in English or Finnish with no date restrictions were included. The search covered records from database inception to August 2024. Results From qualitative studies, we identified three categories describing experiences of innovation competence: Competences for Innovation in Healthcare, Application and Impact of Innovation in Healthcare, and Challenges and Strategies for Implementing Innovation. Quantitative studies identified three conceptual domains: Individual Capacities in Innovation, Innovation‐related Competence Behaviours, and Social and Organisational Enablers. Four categories of factors associated with innovation competence emerged: sociodemographic, career‐related, organisational, and academic factors. Conclusions Healthcare professionals' innovation competence is a multifaceted construct encompassing individual abilities, behavioural expressions, and social and organisational engagement. A systematic and multilevel approach that targets both personal attributes and organisational enablers is needed to strengthen competence. Enhancing innovation competence can improve the healthcare sector's ability to respond to complex challenges and sustain innovation capacity. Impact Findings inform the development of education programmes and leadership strategies to enhance innovation competence among healthcare professionals, supporting innovation implementation in healthcare organisations. Patient or Public Contribution No patient or public involvement was included in this study. Trial Registration PROSPERO: CRD42024614551
目的了解医疗卫生专业人员的创新能力体验及其相关因素；并检查用于评估医疗保健专业人员创新能力及其相关因素的工具。设计一种混合方法的系统评价。方法研究人员分别通过题目和摘要（n = 2996）和全文（n = 189）对原始研究进行独立筛选。纳入18项研究：16项定量研究和2项定性研究。定性数据采用归纳内容分析法进行分析，定量数据采用制表和叙述综合。本研究采用乔安娜布里格斯研究所混合方法系统评价方法。在Scopus、CINAHL、Ovid Medline、ProQuest、Web of Science、PsycArticles和Medic中进行了搜索。以英文或芬兰文发表的文章，没有日期限制。搜索涵盖了从数据库建立到2024年8月的记录。结果通过定性研究，我们将创新能力的经验分为三类：医疗创新的能力、医疗创新的应用和影响、实施创新的挑战和策略。定量研究确定了三个概念领域：创新中的个人能力，创新相关能力行为，以及社会和组织推动者。与创新能力相关的因素有四类：社会人口因素、职业相关因素、组织因素和学术因素。结论卫生保健专业人员的创新能力是一个多方面的结构，包括个人能力、行为表达、社会和组织参与。加强能力需要一种针对个人属性和组织促成因素的系统和多层次方法。提高创新能力可以提高医疗保健部门应对复杂挑战和维持创新能力的能力。影响调查结果告知教育计划和领导策略的发展，以提高医疗专业人员的创新能力，支持医疗机构的创新实施。患者或公众参与本研究不包括患者或公众参与。试验注册号：CRD42024614551
{"title":"Innovation Competence in Healthcare: Individual, Environmental and Organisational Factors—A Mixed‐Method Systematic Review","authors":"Mari Saukkoriipi, Outi Kanste, Erika Jarva, Pauliina Hyrkäs, Kristina Mikkonen","doi":"10.1111/jan.70396","DOIUrl":"https://doi.org/10.1111/jan.70396","url":null,"abstract":"Aims To identify healthcare professionals' experiences of innovation competence and the factors associated with it; and to examine the instruments developed to assess innovation competence and its associated factors among healthcare professionals. Design A mixed‐methods systematic review. Methods Researchers independently screened original studies by title and abstract ( <jats:italic>n</jats:italic> = 2996) and then full text ( <jats:italic>n</jats:italic> = 189). Eighteen studies were included: 16 quantitative and two qualitative. Qualitative data were analysed using inductive content analysis, and quantitative data were tabulated and synthesised narratively. Data Sources The review followed the Joanna Briggs Institute Mixed Methods Systematic Review methodology. Searches were conducted in Scopus, CINAHL, Ovid Medline, ProQuest, Web of Science, PsycArticles, and Medic. Articles published in English or Finnish with no date restrictions were included. The search covered records from database inception to August 2024. Results From qualitative studies, we identified three categories describing experiences of innovation competence: Competences for Innovation in Healthcare, Application and Impact of Innovation in Healthcare, and Challenges and Strategies for Implementing Innovation. Quantitative studies identified three conceptual domains: Individual Capacities in Innovation, Innovation‐related Competence Behaviours, and Social and Organisational Enablers. Four categories of factors associated with innovation competence emerged: sociodemographic, career‐related, organisational, and academic factors. Conclusions Healthcare professionals' innovation competence is a multifaceted construct encompassing individual abilities, behavioural expressions, and social and organisational engagement. A systematic and multilevel approach that targets both personal attributes and organisational enablers is needed to strengthen competence. Enhancing innovation competence can improve the healthcare sector's ability to respond to complex challenges and sustain innovation capacity. Impact Findings inform the development of education programmes and leadership strategies to enhance innovation competence among healthcare professionals, supporting innovation implementation in healthcare organisations. Patient or Public Contribution No patient or public involvement was included in this study. Trial Registration PROSPERO: CRD42024614551","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"36 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim To explore baseline activities of daily living (ADL) profiles and their association with memory decline over time in cognitively healthy, community‐dwelling older adults. Design Observational panel study. Methods This study analysed data from Waves 7–10 of the English Longitudinal Study of Ageing (the search was performed on May 28, 2024), including 2925 older adults aged above 65 with no dementia or cognitive impairments at baseline (Wave 7, 2014–2015). To categorise participants by their daily functional abilities at baseline, latent class analysis was conducted to derive participants' activities of daily living profiles. A linear mixed model was used to explore whether these baseline activity profiles might predict different memory decline rates (trajectories) over time, accounting for baseline demographic factors (gender, age, ethnicity, education, marital status and chronic diseases). Results Social demographics (younger age, female gender, white ethnicity, higher education and being partnered) and ADL profiles outweigh health conditions in predicting participants' memory function. Different baseline profiles were linked to different memory decline trajectories. An impairment profile with grocery shopping capability was linked to slower memory decline. Conclusion This study showed that ADL profiles had a substantial correlation with memory decline, accounting for the significant impact of sociodemographic factors. An impairment profile that preserved grocery shopping abilities appeared to offer protective benefits and potentially slow memory decline. Impact Strengthening nursing strategies that support older adults in maintaining the ability to grocery shop, such as guiding caregivers to promote involvement rather than shopping for the older adults entirely, or accompanying older adults grocery shopping as part of community nursing care, might help delay age‐related memory decline in this population. Patient or Public Contribution Patients or members of the public were not directly involved in the study's design, conduct, reporting, or dissemination plans.
目的探讨认知健康的社区居住老年人日常生活基线活动（ADL）概况及其与记忆衰退的关系。设计观察组研究。本研究分析了英国老龄化纵向研究（the English Longitudinal study of Ageing）第7 - 10波的数据（检索于2024年5月28日进行），包括2925名65岁以上、基线时无痴呆或认知障碍的老年人（第7波，2014-2015）。为了在基线上根据参与者的日常功能能力对其进行分类，进行了潜在类分析，以获得参与者的日常生活活动概况。考虑到基线人口统计因素（性别、年龄、种族、教育程度、婚姻状况和慢性病），研究人员使用线性混合模型来探索这些基线活动概况是否可以预测不同的记忆衰退率（轨迹）。结果社会人口特征（年轻、女性、白人、高等教育程度和伴侣）和ADL特征在预测参与者记忆功能方面比健康状况更重要。不同的基线轮廓与不同的记忆衰退轨迹有关。杂货购物能力受损与记忆衰退速度较慢有关。结论ADL谱与记忆衰退有显著的相关性，说明了社会人口因素的显著影响。保留购物能力的损伤档案似乎提供了保护作用，并可能减缓记忆衰退。加强护理策略，支持老年人保持购买杂货的能力，如指导护理人员促进老年人参与，而不是完全为老年人购物，或陪同老年人购买杂货作为社区护理的一部分，可能有助于延缓老年人与年龄相关的记忆衰退。患者或公众的贡献患者或公众成员没有直接参与研究的设计、实施、报告或传播计划。
{"title":"Association Between Activities of Daily Living Profiles and Memory Decline in Community‐Dwelling Older Adults Without Cognitive Impairment: An Observational Panel Study","authors":"Szu‐Yu Chen, Kuei‐Min Chen, Frank Belcastro","doi":"10.1111/jan.70474","DOIUrl":"https://doi.org/10.1111/jan.70474","url":null,"abstract":"Aim To explore baseline activities of daily living (ADL) profiles and their association with memory decline over time in cognitively healthy, community‐dwelling older adults. Design Observational panel study. Methods This study analysed data from Waves 7–10 of the English Longitudinal Study of Ageing (the search was performed on May 28, 2024), including 2925 older adults aged above 65 with no dementia or cognitive impairments at baseline (Wave 7, 2014–2015). To categorise participants by their daily functional abilities at baseline, latent class analysis was conducted to derive participants' activities of daily living profiles. A linear mixed model was used to explore whether these baseline activity profiles might predict different memory decline rates (trajectories) over time, accounting for baseline demographic factors (gender, age, ethnicity, education, marital status and chronic diseases). Results Social demographics (younger age, female gender, white ethnicity, higher education and being partnered) and ADL profiles outweigh health conditions in predicting participants' memory function. Different baseline profiles were linked to different memory decline trajectories. An impairment profile with grocery shopping capability was linked to slower memory decline. Conclusion This study showed that ADL profiles had a substantial correlation with memory decline, accounting for the significant impact of sociodemographic factors. An impairment profile that preserved grocery shopping abilities appeared to offer protective benefits and potentially slow memory decline. Impact Strengthening nursing strategies that support older adults in maintaining the ability to grocery shop, such as guiding caregivers to promote involvement rather than shopping for the older adults entirely, or accompanying older adults grocery shopping as part of community nursing care, might help delay age‐related memory decline in this population. Patient or Public Contribution Patients or members of the public were not directly involved in the study's design, conduct, reporting, or dissemination plans.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"55 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patricia S Groves,Yelena Perkhounkova,Maria Hein,Peter James Abad
AIMSTo evaluate whether information about patients' poor sense of security in hypothetical vignette scenarios increases nurses' projected intent to report safety events.DESIGNQuantitative, cross-sectional factorial survey vignette experiment administered online.METHODSA convenience sample of 60 nurses from adult inpatient hospital units at a Midwest academic medical center participated in February 2025. Participants responded to demographic questions and eight factorial vignettes, each describing a patient-reported safety breach and incorporating four patient-related factors. Four vignettes included information that the patient had a poor sense of security, and four did not, presented in random order. Following each vignette, participants rated their level of concern about the patient's report, perceived harm to the patient, and likelihood of reporting the patient's concern. A linear mixed-effects modelling approach, accounting for clustering within participants, was used to estimate the effects of the sense of security information factor on nurses' responses.RESULTSThe sense of security information was associated with higher ratings of (a) degree of concern, (b) perceived harm to the patient, and (c) intent to report the patient's concern, after adjusting for vignette- and participant-level covariates. The vignette patient's perception of physical harm was positively associated with all three ratings. Nurses' greater hospital experience was associated with lower ratings across outcomes.CONCLUSIONObtaining information that the patient felt insecure was associated with heightened concern about the safety event, greater perceived harm, and increased intent to report the concern.IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARESense of security assessment may be a risk-agnostic, patient-centered intervention that nurses can routinely perform, regardless of the safety event circumstances.IMPACTAlthough a system of evidence-based practices within a safety culture is essential to hospital safety efforts, nurses' judgements of and responses to patient safety concerns play a critical role and should not be overlooked.REPORTING METHODSTROBE guidelines.PATIENT OR PUBLIC CONTRIBUTIONThis study did not include patient or public involvement in its design, conduct, or reporting.
{"title":"The Impact of Assessing Patients' Sense of Security on Nurses' Intent to Report Safety Events: A Factorial Survey Experiment.","authors":"Patricia S Groves,Yelena Perkhounkova,Maria Hein,Peter James Abad","doi":"10.1111/jan.70483","DOIUrl":"https://doi.org/10.1111/jan.70483","url":null,"abstract":"AIMSTo evaluate whether information about patients' poor sense of security in hypothetical vignette scenarios increases nurses' projected intent to report safety events.DESIGNQuantitative, cross-sectional factorial survey vignette experiment administered online.METHODSA convenience sample of 60 nurses from adult inpatient hospital units at a Midwest academic medical center participated in February 2025. Participants responded to demographic questions and eight factorial vignettes, each describing a patient-reported safety breach and incorporating four patient-related factors. Four vignettes included information that the patient had a poor sense of security, and four did not, presented in random order. Following each vignette, participants rated their level of concern about the patient's report, perceived harm to the patient, and likelihood of reporting the patient's concern. A linear mixed-effects modelling approach, accounting for clustering within participants, was used to estimate the effects of the sense of security information factor on nurses' responses.RESULTSThe sense of security information was associated with higher ratings of (a) degree of concern, (b) perceived harm to the patient, and (c) intent to report the patient's concern, after adjusting for vignette- and participant-level covariates. The vignette patient's perception of physical harm was positively associated with all three ratings. Nurses' greater hospital experience was associated with lower ratings across outcomes.CONCLUSIONObtaining information that the patient felt insecure was associated with heightened concern about the safety event, greater perceived harm, and increased intent to report the concern.IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARESense of security assessment may be a risk-agnostic, patient-centered intervention that nurses can routinely perform, regardless of the safety event circumstances.IMPACTAlthough a system of evidence-based practices within a safety culture is essential to hospital safety efforts, nurses' judgements of and responses to patient safety concerns play a critical role and should not be overlooked.REPORTING METHODSTROBE guidelines.PATIENT OR PUBLIC CONTRIBUTIONThis study did not include patient or public involvement in its design, conduct, or reporting.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"9 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AIMTo explore whether a delay from referral to first contact with nurse-led community health services is associated with the likelihood of subsequent emergency department attendance.DESIGNWe use individual linked administrative data on use of community health and hospital services. We identify a cohort of 343,721 individuals referred to community health services in England by their primary care provider in 2019. We then track their subsequent community healthcare contacts and emergency department attendances.METHODSWe exploit variation in the time to contact caused by weekend delays, which create longer times to first contact for people referred later in the working week. The main analysis compares patients referred on Thursday with those referred on Tuesday.RESULTSWe show that 6.7% of patients referred on Thursday wait an extra two days for their first community contact relative to those referred on Tuesday. Despite this delay, we find no evidence that people referred on Thursday are more likely to have a subsequent emergency department attendance compared to those referred on Tuesday.CONCLUSIONSWe do not find delayed community health services contact to be associated with an increased risk of emergency attendance amongst patients referred to community services by their primary care provider. This suggests that short delays in contact time are not detrimental for this group.IMPACTShifting care from hospital to community settings is a key priority for health systems internationally. In England, community health services face significant staffing shortages, limiting the extent to which services can be responsive and support the desired strategic shift. Our findings suggest that these constrained community providers could use their limited capacity to prioritise responding quickly to other patients without harming those referred via primary care.REPORTING METHODSTROBE guidelines.PATIENT OR PUBLIC CONTRIBUTIONThis study did not include patient or public involvement in its design, conduct, or reporting.
{"title":"Short Delays in Time to First Contact With Community Health Services and Risk of Emergency Hospital Attendance: Retrospective Observational Study.","authors":"Lachlan Cameron,Matt Sutton,Beth Parkinson,Rachel Meacock","doi":"10.1111/jan.70488","DOIUrl":"https://doi.org/10.1111/jan.70488","url":null,"abstract":"AIMTo explore whether a delay from referral to first contact with nurse-led community health services is associated with the likelihood of subsequent emergency department attendance.DESIGNWe use individual linked administrative data on use of community health and hospital services. We identify a cohort of 343,721 individuals referred to community health services in England by their primary care provider in 2019. We then track their subsequent community healthcare contacts and emergency department attendances.METHODSWe exploit variation in the time to contact caused by weekend delays, which create longer times to first contact for people referred later in the working week. The main analysis compares patients referred on Thursday with those referred on Tuesday.RESULTSWe show that 6.7% of patients referred on Thursday wait an extra two days for their first community contact relative to those referred on Tuesday. Despite this delay, we find no evidence that people referred on Thursday are more likely to have a subsequent emergency department attendance compared to those referred on Tuesday.CONCLUSIONSWe do not find delayed community health services contact to be associated with an increased risk of emergency attendance amongst patients referred to community services by their primary care provider. This suggests that short delays in contact time are not detrimental for this group.IMPACTShifting care from hospital to community settings is a key priority for health systems internationally. In England, community health services face significant staffing shortages, limiting the extent to which services can be responsive and support the desired strategic shift. Our findings suggest that these constrained community providers could use their limited capacity to prioritise responding quickly to other patients without harming those referred via primary care.REPORTING METHODSTROBE guidelines.PATIENT OR PUBLIC CONTRIBUTIONThis study did not include patient or public involvement in its design, conduct, or reporting.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"9 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145986212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paediatric nursing has evolved from a limited subset of general nursing to a dynamic specialty grounded in evidence-based practice, family-centred care and technological integration over the past 50 years. The establishment of family-centred care, advances in neonatal intensive care, expanded roles for paediatric nurse practitioners, innovations in chronic disease management and the integration of telehealth and digital solutions were major milestones at that time. Health inequities, rising mental health disorders among youth, paediatric nursing workforce shortages, climate-related health threats and ethical complexities linked to technological advances have emerged during this period. The main aim of this commentary was to reflect on historical achievements, critically examine current barriers to optimal paediatric health outcomes, and propose strategic actions to address systemic gaps. All children worldwide could achieve their full potential by strengthening health equity, integrating mental health services, investing in workforce development, expanding digital health access, enhancing climate and ethical preparedness and promoting paediatric nurse leadership; the next era of paediatric nursing can ensure this. Paediatric nurses remain uniquely positioned as compassionate caregivers, innovators and advocates in the evolving healthcare landscape.
{"title":"Celebrating Five Decades of Paediatric Nursing Progress: Achievements, Persistent Challenges and Future Directions","authors":"Sawsan Abuhammad","doi":"10.1111/jan.17086","DOIUrl":"https://doi.org/10.1111/jan.17086","url":null,"abstract":"Paediatric nursing has evolved from a limited subset of general nursing to a dynamic specialty grounded in evidence-based practice, family-centred care and technological integration over the past 50 years. The establishment of family-centred care, advances in neonatal intensive care, expanded roles for paediatric nurse practitioners, innovations in chronic disease management and the integration of telehealth and digital solutions were major milestones at that time. Health inequities, rising mental health disorders among youth, paediatric nursing workforce shortages, climate-related health threats and ethical complexities linked to technological advances have emerged during this period. The main aim of this commentary was to reflect on historical achievements, critically examine current barriers to optimal paediatric health outcomes, and propose strategic actions to address systemic gaps. All children worldwide could achieve their full potential by strengthening health equity, integrating mental health services, investing in workforce development, expanding digital health access, enhancing climate and ethical preparedness and promoting paediatric nurse leadership; the next era of paediatric nursing can ensure this. Paediatric nurses remain uniquely positioned as compassionate caregivers, innovators and advocates in the evolving healthcare landscape.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"57 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145968851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lisa Labita Woodson,Hanne R Dolan,Leslie V Farland,Jessica G Rainbow
AIMSThis study examined associations between pregnancy-related fear and stress, occupational exposures, and workplace modifications among pregnant registered nurses in the United States engaged in direct patient care.METHODSA cross-sectional design was used with data collected via an online survey between November 2021 and April 2022. Participants (n = 358) were recruited through social media and listservs. Log-binomial regression models, adjusted for age and parity, estimated prevalence ratios and confidence intervals for associations between occupational exposures and workplace modifications with prevalence of pregnancy-related stress at work and fear of pregnancy or infant complications. Stress, a non-specific physical/psychosocial response to demands, and fear, an emotional response to perceived threat, functioned as distinct constructs.RESULTSEmotional and physical environmental hazards were associated with increased prevalence of stress. Emotional and environmental hazards, as well as physical movement, administering antineoplastic medications, infectious disease transmission and scans, were associated with increased prevalence of fear. Each additional occupational exposure increased prevalence of stress by 4% and fear by 12%. Nurses also mitigated risks by implementing workplace modifications. Stress was associated with changing work schedules, while fear was statistically significantly associated with taking extra infection precautions and seeking assistance for CPR.CONCLUSIONSFindings highlight the need for interventions that address modifiable occupational hazards and improve access to modifications that reduce stress and fear among pregnant nurses.IMPLICATIONS FOR THE PROFESSIONStrengthening workplace protections could reduce occupational stress, improve nurse retention and enhance patient care quality.IMPACTPregnant nurses face significant occupational hazards, yet limited research has examined their psychosocial effects and mitigation strategies. This study identified key exposures associated with increased stress and fear and showed that workplace modifications varied by stress/fear levels and pregnancy trimester, informing policies to better protect pregnant nurses.REPORTING METHODAuthors adhered to the STROBE checklist for cross-sectional studies.PATIENT OR PUBLIC CONTRIBUTIONSThis study did not include patient or public involvement in its design, conduct or reporting.
{"title":"Protecting Nurses During Pregnancy: Cross-Sectional Study of Workplace Exposures and Modifications.","authors":"Lisa Labita Woodson,Hanne R Dolan,Leslie V Farland,Jessica G Rainbow","doi":"10.1111/jan.70475","DOIUrl":"https://doi.org/10.1111/jan.70475","url":null,"abstract":"AIMSThis study examined associations between pregnancy-related fear and stress, occupational exposures, and workplace modifications among pregnant registered nurses in the United States engaged in direct patient care.METHODSA cross-sectional design was used with data collected via an online survey between November 2021 and April 2022. Participants (n = 358) were recruited through social media and listservs. Log-binomial regression models, adjusted for age and parity, estimated prevalence ratios and confidence intervals for associations between occupational exposures and workplace modifications with prevalence of pregnancy-related stress at work and fear of pregnancy or infant complications. Stress, a non-specific physical/psychosocial response to demands, and fear, an emotional response to perceived threat, functioned as distinct constructs.RESULTSEmotional and physical environmental hazards were associated with increased prevalence of stress. Emotional and environmental hazards, as well as physical movement, administering antineoplastic medications, infectious disease transmission and scans, were associated with increased prevalence of fear. Each additional occupational exposure increased prevalence of stress by 4% and fear by 12%. Nurses also mitigated risks by implementing workplace modifications. Stress was associated with changing work schedules, while fear was statistically significantly associated with taking extra infection precautions and seeking assistance for CPR.CONCLUSIONSFindings highlight the need for interventions that address modifiable occupational hazards and improve access to modifications that reduce stress and fear among pregnant nurses.IMPLICATIONS FOR THE PROFESSIONStrengthening workplace protections could reduce occupational stress, improve nurse retention and enhance patient care quality.IMPACTPregnant nurses face significant occupational hazards, yet limited research has examined their psychosocial effects and mitigation strategies. This study identified key exposures associated with increased stress and fear and showed that workplace modifications varied by stress/fear levels and pregnancy trimester, informing policies to better protect pregnant nurses.REPORTING METHODAuthors adhered to the STROBE checklist for cross-sectional studies.PATIENT OR PUBLIC CONTRIBUTIONSThis study did not include patient or public involvement in its design, conduct or reporting.","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"46 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145961236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims To develop a grounded theory that explains how formal care service providers experience caring for and supporting persons with early‐onset dementia (EOD). Design A grounded theory approach. Methods Thirty formal care service providers of persons with EOD were recruited from community‐based dementia care facilities in northern and central Taiwan from August 2021 and February 2022 using purposive and theoretical sampling. Transcribed face‐to‐face, semi‐structured interview data were analysed with constant comparative analysis. A theoretical framework was constructed from the data to describe the experience of being a formal care service provider for persons with EOD. Results The core category of ‘client‐as‐partner care’ was the theoretical framework that explained the experience of formal care service providers and described how participants met the needs of persons with EOD. Five categories described the components of the process: (1) identifying clients' characteristics; (2) establishing a personal relationship; (3) enhancing self‐esteem; (4) maintaining dignity; and (5) the influence of family members and community members. The first four categories were interactive and key to delivering client‐as‐partner care; the fifth category could alter any key component and reduce or improve the quality of care. Reflections shared by participants offered a window into the outcomes of successful client‐as‐partner care: quality of life improved for clients and job satisfaction increased for providers. Conclusion The client‐as‐partner care model for persons with EOD required knowledge of the client's unique characteristics, a strong provider‐client relationship, offering strategies tailored to the client's abilities and interests, and fostering independence. Practice Implications Client‐as‐partner care provides a person‐centred approach that enhances support quality for persons with EOD and increases job satisfaction for formal care providers. Successful strategies can inform case management, strengthen support for this population and indirectly improve family caregivers' competencies. Patient or Public Contribution No patient or public contribution. Reporting Method COREQ (COnsolidated criteria for REporting Qualitative research).
{"title":"Client‐as‐Partner Care: A Grounded Theory Study of Formal Care Service Providers for Persons With Early‐Onset Dementia","authors":"Li‐Min Kuo, Hsiao‐Ping Wang, Li‐Kai Huang","doi":"10.1111/jan.70481","DOIUrl":"https://doi.org/10.1111/jan.70481","url":null,"abstract":"Aims To develop a grounded theory that explains how formal care service providers experience caring for and supporting persons with early‐onset dementia (EOD). Design A grounded theory approach. Methods Thirty formal care service providers of persons with EOD were recruited from community‐based dementia care facilities in northern and central Taiwan from August 2021 and February 2022 using purposive and theoretical sampling. Transcribed face‐to‐face, semi‐structured interview data were analysed with constant comparative analysis. A theoretical framework was constructed from the data to describe the experience of being a formal care service provider for persons with EOD. Results The core category of ‘client‐as‐partner care’ was the theoretical framework that explained the experience of formal care service providers and described how participants met the needs of persons with EOD. Five categories described the components of the process: (1) identifying clients' characteristics; (2) establishing a personal relationship; (3) enhancing self‐esteem; (4) maintaining dignity; and (5) the influence of family members and community members. The first four categories were interactive and key to delivering client‐as‐partner care; the fifth category could alter any key component and reduce or improve the quality of care. Reflections shared by participants offered a window into the outcomes of successful client‐as‐partner care: quality of life improved for clients and job satisfaction increased for providers. Conclusion The client‐as‐partner care model for persons with EOD required knowledge of the client's unique characteristics, a strong provider‐client relationship, offering strategies tailored to the client's abilities and interests, and fostering independence. Practice Implications Client‐as‐partner care provides a person‐centred approach that enhances support quality for persons with EOD and increases job satisfaction for formal care providers. Successful strategies can inform case management, strengthen support for this population and indirectly improve family caregivers' competencies. Patient or Public Contribution No patient or public contribution. Reporting Method COREQ (COnsolidated criteria for REporting Qualitative research).","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"146 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145955345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to the Editor: Bridging the Intention-Action Gap: Future Directions for Implementing Acceptable and Feasible Comfort Rounding.","authors":"Xinrui Wang,Hongyan Wang","doi":"10.1111/jan.70480","DOIUrl":"https://doi.org/10.1111/jan.70480","url":null,"abstract":"","PeriodicalId":54897,"journal":{"name":"Journal of Advanced Nursing","volume":"08 1","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145961237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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